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Current Bladder Dysfunction Reports

10.04.2024 | REVIEW

Urological Surgery Training in Low- and Low-Middle-Resource Settings: a Model for Success!

verfasst von: Matthew Trail, Muhammad Zeeshan Aslam

Erschienen in: Current Bladder Dysfunction Reports

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Abstract

Purpose of Review

This review addresses the growing need for enhanced surgical—and specifically urological—training in low- and low-middle-income countries (LLMICs). Outlined are the challenges host and visiting teams face in facilitating such training, the role of international collaborations and the various urological pathologies that necessitate attention.

Recent Findings

Many challenges exist for the successful implementation of urological training in LLMICs. There is a clear need for specific, collaborative and sustainable approaches to address the gap in expertise between high-income countries (HICs) and LLMICs and enhance the delivery of safe, high-quality urological care.

Summary

Advancements made in recent decades to address the deficiency in urological surgery training in LLMICs have been made; however, there remains a gulf in the standard of training between HICs and LLMICs. Ongoing international collaborations with remote mentoring utilising modern technologies will play an instrumental role in enhancing urological surgery training in LLMICs in the coming years.
Literatur
1.
2.
Sgrò A, Al-Busaidi IS, Wells CI, et al. Global surgery: a 30-year bibliometric analysis (1987–2017). World J Surg. 2019;43:2689–98.PubMedCrossRef
3.
•• Meara JG, Leather AJ, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386:569–624. Addressing unmet global surgical needs with suggested areas for development.PubMedCrossRef
4.
Harrison NW, Eshleman JL, Ngugi PM. Ethical issues of the developing world. Br J Urol. 1995;76 Suppl. 2:93–6.PubMedCrossRef
5.
Harrison N. UROLINK: a model for working together in a changing world. BJU Int. 2002;89:1–5.PubMedCrossRef
6.
Lemack GE, Ellsworth P, Davis R, Wachira J. Assessing urological needs in East Africa – founding a partnership with African Medical and Research Foundation (AMREF). J Urol. 2009;181(Suppl 4):191.CrossRef
7.
8.
9.
10.
11.
Orach CG. Health equity: challenges in low-income countries. Afr Health Sci. 2009;9(S2):S49-51.PubMed
12.
Gajewski J, Pittalis C, Lavy C, et al. Anesthesia capacity of district-level hospitals in Malawi, Tanzania, and Zambia: a mixed-methods study. Anesth Analg. 2020;130:845–53.PubMedCrossRef
13.
• Campain N, Mabedi C, Savopoulos V, Payne SR, MacDonagh R. Understanding cultural and logistical contexts for urologists in low-income countries. BJU Int. 2022;129(3):273–9. https://​doi.​org/​10.​1111/​bju.​15690. Importance of awareness of local cultural practices for urologists working within low-income settings.CrossRefPubMed
14.
Walker GJA, Gunasekera P. Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. Int Urogynecol J. 2011;22:127–35.PubMedCrossRef
15.
Muleta M, Hamlin EC, Fantahun M, Kennedy RC, Tafesse B. Health and social problems encountered by treated and untreated obstetric fistula patients in rural Ethiopia. J Obstet Gynaecol Can. 2008;30:44–50.PubMedCrossRef
16.
17.
18.
•• Jedrzejko N, Margolick J, Nguyen JH, et al. A systematic review of global surgery partnerships and a proposed framework for sustainability. Can J Surg. 2021;64:E280–8. Identification of six core pillars key to developing global surgical partnerships between high- and low- and low middle-income countries.PubMedPubMedCentralCrossRef
19.
20.
O’Flynn E, Danial A, Gajewski J. Global surgery education and training programmes—a scoping review and taxonomy. Indian J Surg. 2021;25:1–4.
21.
22.
Magee WP Jr. Evolution of a sustainable surgical delivery model. J Craniofac Surg. 2010;21:1321–6.PubMedCrossRef
23.
Hilton P. Vesico-vaginal fistulas in developing countries. Int J Gynaecol Obstet. 2003;82:285–95.PubMedCrossRef
24.
Tayler-Smith K, Zachariah R, Manzi M, et al. Obstetric Fistula in Burundi: a comprehensive approach to managing women with this neglected disease. BMC Pregnancy Childbirth. 2013;13:1–8.CrossRef
25.
Polan ML, Sleemi A, Bedane MM, et al. Obstetric fistula. In: Debas HT, Donkor P, Gawande A, et al, editors. Disease control priorities, (volume 1): essential surgery. 3rd ed. Washington: World Bank Publications; 2015.
26.
27.
Maheu-Giroux M, Filippi V, Maulet N, et al. Risk factors for vaginal fistula symptoms in Sub-Saharan Africa: a pooled analysis of national household survey data. BMC Pregnancy Childbirth. 2016;16:82.PubMedPubMedCentralCrossRef
28.
29.
Polan ML, Sleemi A, Bedane MM, et al. Obstetric fistula. In Debas HT, Donkor P, Gawande A, et al, editors. Disease control priorities, (volume 1): essential surgery. 3rd ed. Washington: World Bank Publications; 2015.
30.
Kakembo N, Godier-Furnemont A, Nabirye A, et al. Barriers to pediatric surgical care in low-income countries: the three delays’ impact in Uganda. J Surg Res. 2019;242:193–9.PubMedCrossRef
31.
Economist T. Pocket world in figures. London: Profile Books Ltd.; 2020.
32.
COSECSA. College of Surgeons of East, Central and Southern Africa: regulations and syllabus relating to fellowship examination in urology. Arusha: COSECSA; 2016.
33.
Terna Yawe K-D. Faculty of surgery. Training programmes and curricula. Nigeria: West African College of Surgeons; 2014.
34.
Kisa P, Grabski DF, Ozgediz D, et al. Unifying children’s surgery and anesthesia stakeholders across institutions and clinical disciplines: challenges and solutions from Uganda. World J Surg. 2019;43:1435–49.PubMedCrossRef
35.
Osifo OD, Mene AO. Hypospadias repair in a resource-poor region: coping with the challenges in 5 years. J Pediatr Urol. 2010;6:60–5.PubMedCrossRef
36.
World Health Organization, Joint United Nations Programme on HIV/ AIDS. Joint strategic action framework to accelerate the scale-up of medical male circumcision for HIV Prevention in Eastern and Southern Africa: 2012–2014. Geneva: United Nations, WHO; 2011.
37.
Lucas TJ, Toledo C, Davis SM, et al. Case series of glans injuries during voluntary medical male circumcision for HIV prevention – eastern and southern Africa, 2015–2018. BMC Urol. 2020;20:45.PubMedPubMedCentralCrossRef
38.
Yousef Y, Lee A, Ayele F, Poenaru D. Delayed access to care and unmet burden of pediatric surgical disease in resource-constrained African countries. J Pediatr Surg. 2019;54:845–53.PubMedCrossRef
39.
Tambo FFM, Tolefac PN, Ngowe MN, et al. Posterior urethral valves: 10 years audit of epidemiologic, diagnostic and therapeutic aspects in Yaounde gynaeco-obstetric and paediatric hospital. BMC Urol. 2018;18:46.PubMedPubMedCentralCrossRef
40.
Dejene B. Bladder exstrophy management at Tikur Anbesa University Hospital, Addis Ababa. Ethiopia Ethiop Med J. 2013;51:197–202.PubMed
41.
Okafor HU, Ekenze SO, Uwaezuoke SN. Posterior urethral valves: determinants of outcome in a developing country. J Paediatr Child Health. 2013;49:115–9.PubMedCrossRef
42.
Philipo GS, Nagraj S, Bokhary ZM, Lakhoo K. Lessons from developing, implementing and sustaining a participatory partnership for children’s surgical care in Tanzania. BMJ Glob Health. 2020;5:e002118.PubMedPubMedCentralCrossRef
43.
44.
DeVries CR, Price RR. Male-specific diseases. 198 – 201. In: Global surgery and public health: a new paradigm. Sudbury: Jones & Bartlett Learning; 2012.
45.
• Scotland KB, Watson GM. The status of global urology. Curr Bladder Dysfunct Rep. 2020;15:345–51. A summary of the current inequities in access to urological care.CrossRef
46.
Salami SS, George AK, Rais-Bahrami S. Outcomes of minimally invasive urologic surgery in the elderly patient population. Curr Transl Geriatr Exp Gerontol Rep. 2013;2:84–90.CrossRef
47.
• Watson G, Niang L, Chandresekhar S, Natchagande G, Payne SR. The feasibility of endourological surgery in low-resource settings. BJU Int. 2022;130(1):18–25. https://​doi.​org/​10.​1111/​bju.​15770. Exploring the deficiencies in endoscopic urological surgery in low-income settings with suggested areas for development.CrossRefPubMed
48.
Alfa-Wali M, Osaghae S. Practice, training and safety of laparoscopic surgery in low and middle-income countries. World J Gastrointest Surg. 2017;9:13.PubMedPubMedCentralCrossRef
49.
Aslam Z. Is laparoscopic urological training in sub-Saharan Africa a goal worth pursuing? Observations from my experience with IVUmed in Senegal. Urol News. 2019;23:16–9.
50.
Trail M, Thwaini A, Niang L, Aslam Z. Delivering a laparoscopic urology workshop in West Africa: our initial experience in Senegal. Urol News. 2020;1:3.
51.
Krishnan JV, Sheikh M, Niang L, Ndoye M, Aslam Z. A report from the second laparoscopic urology workshop in Dakar, Senegal. Urol News. 2023;27:2.
52.
Biyani CS, Campain N, Moore M, et al. Urolink supporting the development of urological services in Hawassa, Ethiopia. BJU Int. 2019;123:917–20.PubMedCrossRef
53.
• Biyani CS, Bhatt J, Taylor J, Gobeze AA, McGrath J, MacDonagh R. Introducing endourology to a developing country: how to make it sustainable. J Clin Urol. 2014;7:202–7. Addressing the challenges in enhancing access to endoscopic urological surgery in low-income settings.CrossRef
54.
Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Talati J, Lotan Y. Epidemiology of stone disease across the world. World J Urol. 2017;35:1301–20.PubMedCrossRef
55.
Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) results. Seattle: Institute for Health Metrics and Evaluation (IHME).
56.
Lang J, Narendrula A, El-Zawahry A, Sindhwani P, Ekwenna O. Global trends in incidence and burden of urolithiasis from 1990 to 2019: an analysis of global burden of disease study data. Eur Urol Open Sci. 2022;35:37–46.PubMedPubMedCentralCrossRef
57.
Cassell A III, Jalloh M, Ndoye M, et al. Surgical management of urolithiasis of the upper tract–the current trend of endourology in Africa. Res Rep Urol. 2020;12:225.PubMedPubMedCentral
58.
59.
60.
Karim JS, Hachach-Haram N, Dasgupta P. Bolstering the surgical response to COVID-19: how virtual technology will save lives and safeguard surgical practice. BJU Int. 2020;125:E18–9.PubMedPubMedCentralCrossRef
61.
Sturm LP, Windsor JA, Cosman PH, Cregan P, Hewett PJ, Maddern GJ. A systematic review of skills transfer after surgical simulation training. Ann Surg. 2008;248:166–79.PubMedCrossRef
62.
Buckley CE, Kavanagh DO, Traynor O, Neary PC. Is the skillset obtained in surgical simulation transferable to the operating theatre? Am J Surg. 2014;207:146–57.PubMedCrossRef
63.
Livingston P, Bailey J, Ntakiyiruta G, Mukwesi C, Whynot S, Brindley P. Development of a simulation and skills centre in East Africa: a Rwandan-Canadian partnership. Pan Afr Med J. 2014;17:315.PubMedPubMedCentralCrossRef
64.
Taché S, Mbembati N, Marshall N, Tendick F, Mkony C, O’Sullivan P. Addressing gaps in surgical skills training using low-cost simulation at Muhimbili University in Tanzania. Hum Resour Health. 2009;7:64.PubMedPubMedCentralCrossRef
65.
Metadaten
Titel
Urological Surgery Training in Low- and Low-Middle-Resource Settings: a Model for Success!
verfasst von
Matthew Trail
Muhammad Zeeshan Aslam
Publikationsdatum
10.04.2024
Verlag
Springer US
Erschienen in
Current Bladder Dysfunction Reports
Print ISSN: 1931-7212
Elektronische ISSN: 1931-7220
DOI
https://doi.org/10.1007/s11884-024-00750-w

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